Combination feeding: effective tips to make mixed feeding work for you

Combination feeding is a popular choice for parents who want to breastfeed their baby but need a little more flexibility when it comes to feeding. Whether it's due to challenges with exclusive breastfeeding or simply a personal preference, combining the benefits of breastfeeding with bottle feeding through the 'fed is best' philosophy can be a great solution. In this article, we'll explore the concept of combination feeding and provide practical advice on how to make it work for you and your little one.

What is combination feeding?

Mixed feeding, a.k.a. combi feeding or combination feeding, is using breastfeeding alongside bottle feeding. It can offer a chance for another parent or caregiver to bond at feeding time  or for someone to help with night feeds if you need to catch up on some sleep.  You can bottle feed with expressed milk or formula, though generally speaking the NHS advice is to stick with breast milk until at least six months. If you’re struggling to express, or your baby isn’t gaining weight your doctor may recommend moving to formula milk. .

There’s no 'one size fits all' when it comes to mixed feeding and there are a number of options to try it safely if you’re considering it. You could:

• Replace the occasional breastfeed with a bottle feed to try and get your baby used to taking a bottle.

• Replace some breastfeeds with a bottle at nighttime to allow someone else to take the night shift.

• Use a bottle so your partner has a chance to get involved with feeding, while still exclusively giving your baby breast milk.

What are the benefits of combination feeding?

Introducing bottle feeding can give you some much-needed time off from your milk rounds, but there are other reasons to consider combi feeding.

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If your baby isn't gaining weight or is finding it difficult to latch on, you might be advised by a medical professional to try to combine bottle feeding with breastfeeding. Supplementing your feeding with a bottle can take the pressure off both you and baby, and it could help you if you’ve been stressed about issues like weight gain.

For mothers returning to work, combined feeding allows another carer to bottle feed. Breastfeeding your baby when you get home from work can then be a great way for you both to reconnect before bedtime. Some women express their breast milk at or before work, and you’ll soon find a routine that suits you and your baby.

What else do I need to know about mixed feeding?

Mixed feeding may sound like the perfect balance between breast and bottle, but with the pros inevitably comes the cons.

It’s worth remembering that milk production is a supply-and-demand game. The more you feed your baby, the more milk you’ll continue to produce, so if you drop a feed, your supply will drop too.

A lot can be said for introducing mixed feeding as gradually as possible so that it's more comfortable for you when it comes to engorged breasts and unused milk. The older your baby is when you first introduce a bottle, the more established your milk supply will be and, ultimately, the easier you may find it to balance breast and bottle.

Is mix feeding OK for newborns?

Some women find that mixed feeding from birth is the right choice for them, particularly if they've had multiple births or given birth to a premature or poorly baby.

If you don’t fall into one of those categories, it's often recommended that parents wait until breastfeeding is firmly established before introducing a bottle – the NHS say that this can take several weeks.

Other organisations, such as the World Health Organisation (WHO), recommend waiting up to six months.

Will my milk dry up if I mix feed my baby?

It's common for new mums to worry about milk supply, even without the introduction of mixed feeding. This might be when the initial feeling of fullness in your breasts subsides, or because your baby is particularly hungry while going through a growth spurt.

If you remain concerned about your milk supply, speak to your health visitor or contact your local breastfeeding support group for advice.

What Mumsnet users say

"When mine were breastfeeding some years ago, we were told to eat oats to help milk production. Flapjacks or porridge were my favourites! Best thing to do though is drink masses, rest and try not to worry about it." Tidypidy

"Fennel tea and fenugreek capsules worked for me. The fenugreek does make your skin smell a bit funny!" HelloDulling

How can I successfully combine breastfeeding with bottle feeding?

1. Expressing milk between feeds is key to maintaining your milk supply if you want to continue to breastfeed.

2. If you're returning to work, introducing combined feeding a few weeks before will help prevent mastitis. Gradually replacing breastfeeds with bottle feeds will allow your body time to get used to the change in your milk supply. This will help prevent engorged and leaky breasts and blocked milk ducts.

How do I express milk for bottle feeding?

1. Try to relax: Easier said than done, we know, but the hormone oxytocin causes the milk in your breasts to be released (let-down) and it’s released when you’re feeling happy and relaxed. Find a comfortable seat, take a few deep breaths, make a conscious effort to put your mind at ease and use your senses to help trigger milk release. Holding or being near to your baby can help.

2. Start by using your hands: skin-to-skin contact will help to stimulate the let-down reflex. Your hands can remove milk from parts of your breast which the pump can’t.

3. Consider using a breast pump: Once you’ve stimulated the let-down you could try using a breast pump to remove more milk. There are lots of different pumps on the market, take a look at our buyer’s guide to find the best breast pump for your needs.

Visit the NHS website for more tips on expressing.

How do I introduce my baby to a bottle for the first time?

If you want to give mixed feeding a go, or even switch from breastfeeding to bottle feeding, you might be wondering where to start.

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When a baby feeds from the breast, they use a unique movement called peristaltic tongue movement. This basically means that they use their tongue to massage the underside of the nipple, which results in the milk ejection reflex. Traditionally, when a baby was to feed from a bottle, they would use a completely different style of feeding, which explains why babies would become confused and refuse to switch between breast and bottle.

Because of this reason, it’s really important that you select a teat that will allow your baby to use the exact same technique as when they’re feeding at the breast. MAM’s SkinSoft™ silicone teats do just this.

For optimal success, try the following tips:

• Give your baby their first bottle at a moment when they're happy. Waiting until they are hungry and a bit cranky may not yield the best results.

• Let someone else give the first bottle. This eliminates any chance of your baby smelling your milk and wanting to latch on.

• If someone else isn’t available to give the first bottle, try holding your baby in a different position, such as facing away from you.

Remember that introducing bottle feeding can require patience and persistence. While some babies take to the bottle straight away, in most cases it can take a few attempts to get them used to it. If your baby isn’t playing ball, don’t panic. Try again another time.

What do I need for mixed feeding?

1. A baby bottle

Mumsnet Best winners the MAM Easy Start™ Anti-Colic Bottle is universally beloved by parents, this clever bottle is self-sterilising, leak-proof and surprisingly budget-friendly. The silicone teat has been designed with a soft, flat shape to mimic the nipple when breastfeeding, and the vented, removable base prevents the baby from swallowing too much air. Plus, the self-sterilising function is perfect for when you’re out and about. In fact, MAM’s teats have a 94% teat acceptance rate amongst babies.

2. A breast pump if you're expressing milk

The MAM 2-in-1  has been awarded Mumsnet Best and offers flexibility and convenience for pumping mums and is especially ideal for on-the-go mums or parents returning to work following their maternity leave. It can be used as a manual or electric breast pump, reducing the amount of kit you have.

You can read our full review of the MAM 2-in-1 breast pump here or check out our roundup of the best breast pumps, according to Mumsnetters.

3. A baby bottle steriliser

When it comes to sterilising, speed and convenience are two key things to consider, which is why a microwave steam steriliser is often recommended by Mumsnetters to expectant parents. MAM’s microwave steam steriliser is a great, affordable option that doesn’t take too much space up on your kitchen counter. It can sterilise up to six bottles in just four minutes, fits the majority of microwaves and is even suitable for cold water sterilisation.

Can I restart sole breastfeeding once I've started introducing bottle feeding?

If you find that you have a change of heart and want to pick up extra breastfeeds again, the following tips will help you to get breastfeeding re-established:

• Continue to express milk while bottle feeding as this will keep your supply active. Even if you only express a tiny amount of milk, the nipple stimulation will send milk production signals to your body.

• Skin-to-skin contact will encourage your body to produce milk. Putting your baby to your breast every two to three hours or bottle feeding near the breast will help. Other good skin-to-skin times will be when your baby is full and ready to sleep.

• Don’t wait until your baby is hungry to restart breastfeeding. Instead, choose a time of day when she is happy and more likely to try feeding from the breast again.

About MAM

We’re MAM and we love babies. We believe that only the best is good enough for them! That’s why for over 45 years we’ve been developing extra-safe baby products that combine attractive, innovative design with proven medical benefits. So, parents can feel confident, and babies feel good.